| Objectives To explore the cognitive function and serum brain-derived neurotrophic factor level in patients with obsessive-compulsive disorder, and analysis the changes of cognitive function and serum brain-derived neurotrophic factor level after drug treatment, and to provide theoretical basis for the pathophysiology and clinical treatment of obsessive-compulsive disorder.Methods According to the diagnostic criteria of obsessive-compulsive disorder in 《Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition》(DSM-V), 60 patients with obsessive-compulsive disorder(obsessive-compulsive disorder group) were selected randomly. 60 healthy volunteers were selected as control group(healthy control group), whose sex, age and level of education were matched with the patients. The Yale-Brown obsessive- compulsive scale(Y-BOCS), MATRICS Consensus Cognitive Battery(MCCB), and enzyme-linked immunosorbant assay(ELISA) were adopted to evaluated the clinical severity, cognitive functionand the serum brain-derived neurotrophic factor level. It includes:(1)Trail Making A Test(TMT-A);(2)Brief Assessment of Cognition in Schizophrenia: Symbol Coding(BACS-SC);(3)Hopking Verbal Learning Test-Revised(HVLT-R);(4)Wechsler Memory Scale-Ⅲ(WMS-Ⅲ): Spatial Span;(5)Neuropsychological Assessment Battery:Mazes(NAB);(5)Brief Visuospatial Memory Test-Revised(BVMT-R);(7)Category Fluency: Animal Naming (CF). 2. 25 patients were incorporated into the comparison of cognitive function and BDNF level before and after the drug treatment in OCD group who insisted taking sertraline12 weeks. Using SPSS17.0 statistical software,(1) The differences of cognitive function and serum brain-derived neurotrophic factor level were analyzed by independent sample t test between the patients with obsessive-compulsive disorder and control group.(2) The changes were analyzed by paired two sample t test about cognitive function and serum brain-derived neurotrophic factor level before and after drug treatment.(3)The relationship was compared by Spearman rank correlation between the severity, cognitive function and serum BDNF level in the patients with obsessive-compulsive disorder.Results 1. General clinical data comparison The differences of 60 patients with OCD and 60 healthy people between gender(x2 = 0.038, p = 0.038), age(t = 0.305, p = 0.761) and level of education(t = 0.201, p = 0.201) were not significant. 2. The comparison between patients with OCD and the control group 2.1 The comparison of cognitive function: The test results of cognitive function in patients with obsessive-compulsive disorder were poorer than the control group, and the difference was statistically significant(p< 0.05). 2.2 The comparison of serum BDNF level: The serum BDNF level(10.26±1.51) in patients with OCD was significantly lower than the control group of BDNF level(26.83±3.04), and the difference was statistically significant( p < 0.05). 3. The comparison of before and after drug treatment in patients with OCD 3.1 The comparison of cognitive function before and after treatment 3.1.1 The comparison of processing speed test results TMT- A: The time(40.95±22.56) that patients with OCD completed the test after drug treatment was significantly shorter than before treatment(48.15±22.31), and the difference was statistically significant(p < 0.05); CF: The numbers(20.92 ± 4.81) of animal named in patients after drug treatment were significantly more than before drug treatment(18.80±4.80), and the difference was statistically significant(p < 0.05). 3.1.2 The comparison of verbal and visual learning and memory test results HVLT- R: The grades in patients after drug treatment were higher than before, and the difference was statistically significant(p < 0.05); BVMT- R: The BVMT- R1 score(8.32±2.53) in patients after drug treatment was higher than before(6.48±2.47), the BVMT- R2 score(10.88±1.51)was also higher than before(9.60 ± 2.68), the total score(30.60 ± 4.89)was higher than before(26.88± 6.18), and the differences were both statistically significant(p < 0.05); 3.1.3 The comparison of reasoning and problem solving NAB: The maze A, C, E, G scores in patients after drug treatment were higher than before, and the differences were statistically significant(p < 0.05). 3.2 The comparison of serum BDNF level before and after drug treatment The serum BDNF level(20.48±2.79) in patients after drug treatment was higher than before(10.55±1.70), and the difference was statistically significant( p < 0.05). 4. The correlation analysis between severity and serum BDNF level The serum BDNF level had a negative correlation with severity(r = 0.266, p < 0.05), and it had a negative correlation with obsessive thoughts(r = 0.281, p < 0.05).Conclusions 1. The patients with obsessive-compulsive disorder exist extensive cognitive function damage which is in memory, attention, learning, reasoning and problem solving and executive function, etc. And the serum BDNF level in patients is under the normal level. 2. The serum BDNF level in patients increases, and cognitive function is improved after drug treatment. 3. Drug therapy can increase the serum BDNF level in OCD patients, and improve cognitive function. The serum BDNF level is associated with clinical severity in patients with obsessive-compulsive disorder. |
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